[68Ga]Pentixafor-PET/CT for imaging of chemokine receptor 4 expression in small cell lung cancer - initial experience
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Constantin Lapa1,*, Katharina Lückerath1,*, Martina Rudelius2, Jan-Stefan Schmid1, Alexander Schoene3, Andreas Schirbel1, Samuel Samnick1, Theo Pelzer4, Andreas K. Buck1, Saskia Kropf5, Hans-Jürgen Wester6 and Ken Herrmann1,7
1 Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
2 Institute for Pathology, University of Würzburg, Würzburg, Germany
3 Department of Internal Medicine, Caritas Hospital Bad Mergentheim, Bad Mergentheim, Germany
4 Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany
5 Scintomics GmbH, Fürstenfeldbruck, Germany
6 Pharmaceutical Radiochemistry, Technische Universität München, Munich, Germany
7 Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
* These authors have contributed equally to this work
Constantin Lapa, email:
Keywords: small cell lung cancer, SCLC, molecular imaging, CXCR4, PET
Received: January 11, 2016 Accepted: January 16, 2016 Published: January 28, 2016
Chemokine receptor CXCR4 is a key factor for tumor growth and metastasis in several types of human cancer. This study investigated the feasibility of CXCR4-directed imaging of small cell lung cancer (SCLC) with positron emission tomography/computed tomography (PET/CT) using the radiolabelled chemokine ligand [68Ga]Pentixafor.
10 patients with primarily diagnosed (n=3) or pre-treated (n=7) SCLC (n=9) or large cell neuroendocrine carcinoma of the lung (LCNEC, n=1) underwent [68Ga]Pentixafor-PET/CT. 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG, n=6) and/or somatostatin receptor (SSTR)-directed PET/CT with [68Ga]DOTATOC (n=5) and immunohistochemistry (n=10) served as standards of reference.
CXCR4-PET was positive in 8/10 patients and revealed more lesions with significantly higher tumor-to-background ratios than SSTR-PET. Two patients who were positive on [18F]FDG-PET were missed by CXCR4-PET, in the remainder [68Ga]Pentixafor detected an equal (n=2) or higher (n=2) number of lesions. CXCR4 expression of tumor lesions could be confirmed by immunohistochemistry.
Non-invasive imaging of CXCR4 expression in SCLC is feasible. [68Ga]Pentixafor as a novel PET tracer might serve as readout for confirmation of CXCR4 expression as prerequisite for potential CXCR4-directed treatment including receptor-radio(drug)peptide therapy.
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